Evidence map›Paper›PMID 38267590›Full record

ArticlePediatric nephrology (Berlin, Germany)2024

Use of ClearGuard HD caps in pediatric hemodialysis patients.

Amy Nau, Troy Richardson, Diana Cardwell, Jennifer Ehrlich, Jyothsna Gattineni, Melisha Hanna, Mahima Keswani, Emily Neibauer, Kelly Nitz, Raymond Quigley and 4 more

Erratum issuedAbstract readMulticenter Study
In one paragraph

Article in Pediatric nephrology (Berlin, Germany), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors.

Amy NauDivision of Pediatric Nephrology, Children's Mercy Kansas City, Kansas City, MO, USA. aenau@cmh.edu.ORCID 0009-0002-0207-2756
Troy RichardsonChildren's Hospital Association, Lenexa, KS, USA.
Diana CardwellDivision of Pediatric Nephrology, Children's Health Dallas, Dallas, TX, USA.
Jennifer EhrlichDivision of Pediatric Nephrology, Stead Family Children's Hospital, University of Iowa, Iowa City, IA, USA.
Jyothsna GattineniDivision of Pediatric Nephrology, Children's Health Dallas, Dallas, TX, USA.
Melisha HannaDivision of Pediatric Nephrology, Children's Hospital Colorado, Aurora, CO, USA.
Mahima KeswaniDivision of Pediatric Nephrology, Ann and Robert H. Lurie Children's Hospital, Chicago, IL, USA.
Emily NeibauerDivision of Pediatric Nephrology, Children's Hospital of Wisconsin, Milwaukee, WI, USA.
Kelly NitzDivision of Pediatric Nephrology, Children's Mercy Kansas City, Kansas City, MO, USA.
Raymond QuigleyDivision of Pediatric Nephrology, Children's Health Dallas, Dallas, TX, USA.
Michelle RheaultDivision of Pediatric Nephrology, Children's Minnesota, Minneapolis, MN, USA.
Rebekah SimsDivision of Pediatric Nephrology, Children's of Alabama, Birmingham, AL, USA.
Mayna WooDivision of Pediatric Nephrology, Stanford Medicine-Children's Health, Lucile Packard Children's Hospital, Palo Alto, CA, USA.
Bradley A WaradyDivision of Pediatric Nephrology, Children's Mercy Kansas City, Kansas City, MO, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBloodstream infections (BSIs) are a leading cause of hospitalizations and mortality among patients receiving hemodialysis (HD) therapy, especially those with a central venous catheter (CVC) for dialysis access. The use of chlorhexidine impregnated catheter caps (ClearGuard) has been associated with a decrease in the rate of HD catheter-related BSIs (CA-BSIs) in adults; similar data have not been published for children.

methodsWe compared CA-BSI data from participating centers within the Standardizing Care to Improve Outcomes in Pediatric Endstage Kidney Disease (SCOPE) collaborative based on the center's use of ClearGuard caps for patients with HD catheter access. Centers were characterized as ClearGuard (CG) or non-ClearGuard (NCG) centers, with CA-BSI data pre- and post-CG implementation reviewed. All positive blood cultures in participating centers were reported to the SCOPE collaborative and adjudicated by an infectious disease physician.

resultsData were available from 1786 SCOPE enrollment forms completed January 2016-January 2022. January 2020 served as the implementation date for analyzing CG versus NCG center data, with this being the time when the last CG center underwent implementation. Post January 2020, there was a greater decrease in the rate of HD CA-BSI in CG centers versus NCG centers, with a decrease from 1.18 to 0.23 and 0.41 episodes per 100 patient months for the CG and NCG centers, respectively (p = 0.002).

conclusionsRoutine use of ClearGuard caps in pediatric dialysis centers was associated with a reduction of HD CA-BSI rates in pediatric HD patients.

Indexed as

Catheter-Related InfectionsCentral Venous CathetersChlorhexidineKidney Failure, ChronicRenal DialysisAdolescentAnti-Infective Agents, LocalCatheterization, Central VenousChildChild, PreschoolFemaleHumansMaleAnti-Infective Agents, LocalChlorhexidineCA-BSICapClearGuardHemodialysisPediatric

Identifiers

PMID38267590
PMCPMC11147870

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.